Tuesday, May 29, 2012

Study: Breast is (possibly slightly the) best

According to a study done at the Arkansas Children’s Nutrition Center and published in the journal Pediatrics, and reported on by WebMD, breast milk-fed infants showed slightly higher mental development at 6 and 12 months, and slightly improved language skills at the same ages. Breast-fed infants performed higher than milk or soy formula fed babies at psychomotor skills at 6 months.

This is all very interesting. And I’m sure, given the battle over breast feeding, that these findings will go to bolster the “breast is best” crowd. But there are a couple of points I’d like to raise in the debate in deference to fairness and completeness.

First, the researchers point out the differences between breastfed and formula-fed infants “were quite small after adjusting for other factors, like being small for gestational age, etc.” So, when you factor out stuff that gives infants an advantage anyway, the difference between breastfed and formula fed was “quite small.”

The second is another point the researchers are working on: they are following the infants until age 6 to see if the advantages to breastfed babies disappear (or grow larger). This is important, because no matter how rigorous a learning regime a parent constructs for an infant, most of the advantages have disappeared by age 5. Humans have genetic and developmental limits to their learning ability. True, a baby that learns 100 words before any of his peer group learns 50 is ahead at the start. But if 2,000 words is the vocabulary limit for a 10-year-old brain, your child is likely to know 2,000 words, regardless of how many he knew when he was 2. Likewise, if your child is IQ 100, knowing 100 words before anyone else knows 50 won’t be of significant help to him. His IQ is 100 regardless and any quick start will only result in a regression to the mean. While its true that you can learn teach a child critical thinking skills to help them out, genetically a child has X as its upper limit for achievement and intellect. No amount of studying changes this. Twin and triplet studies have shown this over and over again: Identical children seperated at birth tend to end up with the same intellect and earning potential, regardless of upbringing. Nurture can sway a child while that child is young, but over the long road, its genes that matter.

This is a long way of saying that any benefit derived from breastfeeding may not be "real," or at the very least, may not be permanent.

Finally, its possible this is a causation, correlation issue. Yes, breastfed babies appear to have a slight head start. But its possible that the advantages derive not from being breastfed but from something else altogether. Say, perhaps, that Moms who breastfeed, and continue to do so after the first few weeks, are likely to be more present in their children’s lives, less likely to be working Moms, and more likely to be educated and devoted. I’m not saying its the case, but its possible. Breastfeeding certainly entails some physical struggle that bottles do not.

In this way, its very close to the problems with studies evaluating television watching. TV viewing is sometimes linked to several delays and problems, but, as with breastfeeding, is it that TV is bad, or that bad parents rely too heavily on TV.

It’s completely possible that parents of unwanted pregnancies or parents who otherwise aren’t truly invested in parenting don’t want to go through the trouble of breastfeeding and so rely on formula. That doesn’t make the formula bad. Bad choices make bad parents bad, but the choices they make aren’t always bad.

UPDATE: This isn't to say you shouldn't breastfeed your baby, or that I don't support breastfeeding, or that I encourage formula feeding. My triplets were not breastfed for somewhat obvious reasons, but I think breastfeeding makes heaps of sense, even if it provides no developmental advantage. If nothing else, its the cheaper option. I also think it provides lots of mothers with a nice post-delivery feeling of connectedness. What I don't like is some of the more virulent supporters of breastfeeding who seem to think that breast is the only option or that not breastfeeding somehow makes you an inferior parent. I do not believe the evidence suggest that that is the case.

Sometimes I wish we could all just admit that "I do X because I enjoy it" without having to shoehorn whatever X is (in this case breastfeeding) into providing benefits for someone/something else. Breastfeeding may be best for you and your family, and that is great; that doesn't make it wrong for another family.